Indolent T-cell lymphoma of the gastrointestinal tract coexisting with gastric signet-ring cell carcinoma: A case report and review of literature

Figure 1 Endoscopic images and computed tomography image of the upper abdomen and pathological characteristics of the lesser curvature of the gastric body. A: Upper gastrointestinal endoscopy demonstrated diffuse mucosal edema and erythema throughout the gastric fundus, body, and antrum with poor expansion of the gastric cavity after inflation; B: A 1.5 cm mucosal protrusion on the greater curvature; C: Multiple superficial erosions in the descending duodenum with surrounding mucosa exhibiting a finely granular pattern; D: Computed tomography revealed irregular circumferential wall thickening involving the gastric body and antrum and moderate enhancement on an enhanced scan; E: Diffuse infiltrate of the signet-ring cell carcinoma in the lesser curvature of the gastric body (hematoxylin eosin, 400 ×); F: Immunohistochemical staining confirmed that the tumor cells were strongly diffusely positive for CK8 (EnVision method, 200 ×).

Figure 2 Pathological characteristics of indolent gastrointestinal T-cell lymphoma in the greater curvature of the gastric body. A: The lamina propria is expanded by a dense, nondestructive infiltrate of small lymphocytes [hematoxylin eosin (HE), 100 ×]; B: The lymphocytes displayed round or slightly irregular nuclei, fine chromatin, indistinct nucleoli, and scant cytoplasm (HE, 400 ×); C: Indolent gastrointestinal T-cell lymphoma (GITCL) was negative for AE1/AE3 (EnVision method, 200 ×); D: Indolent GITCL was positive for CD3 (EnVision method, 200 ×); E: Indolent GITCL displayed diffuse and strong positivity for CD5 (EnVision method, 200 ×); F: Indolent GITCL was positive for CD7 (EnVision method, 200 ×); G: Indolent GITCL was negative for CD4 (EnVision method, 200 ×); H: Indolent GITCL was positive for CD8 (EnVision method, 200 ×); I: Indolent GITCL was positive for CD8 (EnVision method, 400 ×); J: Indolent GITCL was positive for TIA-1 (EnVision method, 200 ×); K: Indolent GITCL was positive for TIA-1 (EnVision method, 400 ×); L: The Ki-67 proliferation index was < 10% (EnVision method, 200 ×); M: Epstein-Barr virus encoded RNA's was negative; N and O: T-cell receptor (TCR) test revealed that the TCRB Tube-B TCRB νβ-Јβ2 was positive.